Wellcare of New Jersey, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WELLCARE OF NEW JERSEY, INC.

Doing business as

Wellcare Home Mobility

Practice address

410 Garibaldi Ave
Unit B
Lodi, NJ 07644-3710

Phone

(973) 777-3196

Fax

(973) 777-3195

NPI assigned

Nov 8, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Daniel Jackson

Title

President

Phone

(973) 777-3196

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Wellcare Home Mobility Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1427039379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 GARIBALDI AVE",
            "address_2": "UNIT B",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076443710",
            "telephone_number": "973-777-3196",
            "fax_number": "973-777-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 GARIBALDI AVE",
            "address_2": "UNIT B",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076443710",
            "telephone_number": "973-777-3196",
            "fax_number": "973-777-3195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE OF NEW JERSEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-777-3196",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "PA",
            "license": "3000007639",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8866309",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009640730001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellcare Home Mobility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Qing Hua Zheng

• Durable Medical Equipment & Medical Supplies in Lodi, NJ
• Providers in Lodi, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.